The optimal duration of treatment of ventilator-associated pneumonia (VAP) is still the subject of debate. While 1-week treatment has been reported as possibly sufficient, patients generally receive antibiotic therapy for 10-14 days. The purpose of our study was to investigate whether length of treatment in patients with VAP can be reduced with an individualized therapeutic strategy. The study was performed prospectively with patients diagnosed with VAP in our hospital's intensive care units between 1 January and 31 December, 2015...

The aim of the study was to investigate the prevalence of PMQR genes in an unselected collection of bloodstream isolates recovered over an 18-month period in a laboratory affiliated to a University Hospital in Athens, Greece and to assess their impact on the in vitro activity of ciprofloxacin and levofloxacin. Eight PMQR genes were screened by PCR and sequencing. All PMQR-positive isolates were submitted to isoelectric focusing for β-lactamase detection, conjugation or transformation, time-kill assays, MPC and inoculum effect evaluation...

Enterobacter aerogenes and Enterobacter cloacae complex are the species of this genus most involved in healthcare-associated infections (HAIs), that are ESBL and carbapenemase producers. This study has characterized phenotypically and genotypically 51 isolates of E. aerogenes and E. cloacae complex as originated from infection or colonization in patients admitted to public hospital in Recife, Pernambuco, Brazil, by antimicrobial susceptibility profile, analysis of β-lactamase genes (blaTEM, blaSHV, blaCTX-M, blaKPC, blaVIM, blaIMP and blaSPM), PCR and DNA sequencing, plasmid profile and ERIC-PCR...

In this study, we analysed phenotypic resistance profiles and their reflection in the genomic profiles of Enterococcus spp. strains isolated from pigs raised on different farms. Samples were collected from five pig farms (n=90 animals) and tested for Enterococcus. Minimum inhibitory concentrations of 12 antimicrobials were determined using the broth microdilution method, and epidemiological molecular analysis of strains belonging to selected species (E. faecalis, E. faecium and E. hirae) was performed using the ADSRRS-fingerprinting method with a few modifications...

The objective of the present study was to evaluate the prevalence of intestinal colonization with extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-E) and carbapenemases-producing Enterobacteriaceae (CPE) in non-selected hospitalized and non-hospitalized patients from the same geographic area of Madrid. Among the 501 patients enrolled, 43 (8.6%) carried ESBL-E and 8 (1.6%) patients exhibited CPE. The main intestinal colonizer among ESBL-E was CTX-M-producing Escherichia coli isolates in both settings (community and hospital)...

The objective of the present study is to investigate the diverse resistance determinants, their association with IS mobile elements and predilection of a particular clone for such associations in A. baumannii. Fifty-four consecutive isolates collected during 2011-2012 from a tertiary care hospital were subjected to susceptibility testing followed by PCR screening of commonly reported β-lactamases and 16S rRNA methyl transferase encoding genes. The integrity of RND efflux pump related genes in their respective operons was also investigated...

We investigated the expression levels of virulence factors (ompA, omp33-36, and carO) in 5 clinical isolates and in a standard ATCC19606 strain of Acinetobacter baumannii to determine their effect on the virulence characteristics of the isolates. The mRNA levels of ompA in the clinical isolates were higher and similar compared with those in ATCC19606, whereas the mRNA levels of omp33-36 in the clinical isolates were lower and similar compared with those in ATCC19606. The mRNA levels of carO in the clinical isolates were significantly higher than those in ATCC19606...

The global regulator cAMP receptor protein (CRP) has been shown to be required for the full virulence and/ or for the expression of virulence determinants in a wide set of bacterial pathogens. In this work, the crp mutant as well as the complemented mutant was constructed from a wild-type Klebsiella pneumoniae capsular serotype K1 strain causing the primary pyogenic liver abscess. The phenotypes of wild-type strain, crp mutant, and complemented mutant were characterized systematically. It was disclosed that K...

Escherichia coli clonal group A (CGA) causes urinary tract and other extraintestinal infections in humans. CGA is an important cause of trimethoprim/sulfamethoxazole (SXT)-resistance in extraintestinal pathogens. We examined the extent to which resistance in this area is related to CGA dissemination of E. coli from urinary tract infections (UTIs) in Mexico City. The virulence backgrounds of the isolates were also characterized. In this study, the frequency of resistance to SXT used for UTI treatment was high (56-65%) and CGA isolates accounted for 9 of the 78 SXT-resistant isolates (11...

We investigated the clinical features of intensive care unit (ICU) patients with a concomitant severe dengue infection and bacteremia to identify risk factors for this comorbidity. The records of all ICU dengue patients admitted during a July 31-November 31, 2015 were reviewed. Patients with "concurrent bacteremia" (positive bacterial blood culture within 72 hours of ICU admission) were identified. ICU admission was required for 142 patients; 22 (15.5%) had concurrent bacteremia. Streptococcus spp. was the most common pathogen, then Escherichia coli, and then Staphylococcus spp...

The annual prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in Malaysia has been estimated to be at 30-40% of all S. aureus infections. Nevertheless, data on the antimicrobial resistance and genetic diversity of Malaysian MRSAs remain few. In 2009, we collected 318 MRSA strains from various wards of our teaching hospital located in Kuala Lumpur, the capital city of Malaysia, and performed antimicrobial susceptibility testing on the strains. The strains were then molecularly characterized via SCCmec and virulence gene (cna, sea, seb, sec, sed, see, seg, seh, sei, eta, etb, PVL and TSST-1) typing; a subset of 49 strains isolated from the Intensive Care Unit (ICU) were also typed using Pulsed-Field Gel Electrophoresis (PFGE)...

The Herpes Zoster (HZ) is an acute viral illness characterized by a vesicular rash, with unilateral distribution, which can eventually cause severe complications, such as the post-herpetic neuralgia (PHN), the ophthalmic zoster, stroke or other neurological complications. In Europe, an incidence between 2.0 and 4.6 cases per 1,000 persons-year is estimated, with an increase after 50 years of age. Currently, the therapeutic options for HZ are only partially effective to limit the acute phase, while the management of complications is frequently complex and not satisfactory...

The global emergence of antibiotic resistant strains of Pseudomonas aeruginosa poses a major threat in hospital environments as well as in the community. P. aeruginosa is an opportunistic human pathogen and it also infects a wide range of model organisms including the nematode Caenorhabditis elegans. Quorum sensing (QS) mediates cell-to-cell communication in bacteria and has an important role in regulating virulence genes, antibiotic resistance and biofilm formation which are crucial for establishment of the infection...

Toxigenic corynebacteria are uncommon in the UK, however laboratory confirmation by the national reference laboratory (NRL) can inform public health action according to national guidelines. Standard phenotypic tests for identification and toxin expression of isolates can take from ≥24 h to ≥48 h, from receipt. To decrease the time to result, a real-time PCR (qPCR) assay was developed for confirmation of both identification of Corynebacterium diphtheriae and Corynebacterium ulcerans/ Corynebacterium pseudotuberculosis and detection of the diphtheria toxin gene...

Bacterial pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) represent a well-known public health problem affecting both healthcare-associated and community populations. Past studies have clearly shown the value of characterizing problem organisms including MRSA through the use of molecular techniques (i.e., strain typing), with the aim of informing local, regional, and national efforts in epidemiological analysis and infection control. The country of Libya represents a challenge for such analysis due to limited historical infectious disease information and major political unrest culminating in the Libyan Civil War (Libyan Revolution) in 2011...

The rising rates of invasive fungal infections caused by non-albicans Candida and the increasing emergence of antifungal resistance complicate the management of invasive candidiasis. Accurate and timely antifungal susceptibility testing is critical to targeting antifungal therapy. The purpose of this study was to compare commercially available susceptibility testing methods using prospectively collected Candida isolates. Susceptibility testing was performed on 74 Candida isolates collected from July 2014-March 2015 using broth microdilution (BMD) according to the Clinical and Laboratory Standards Institute (CLSI) method, Etest, Vitek2 (YS-05), and Sensititre...

Staphylococcus aureus carriers are at higher risk of S. aureus infection and are a reservoir for transmission to others. Detection of nasal S. aureus carriage is important for both targeted decolonisation and epidemiological studies. Self-administered nasal swabbing has been reported previously, but the impact of posting swabs prior to culture on S. aureus yield has not been investigated. A longitudinal cohort study was performed in which healthy volunteers were recruited, trained in the swabbing procedure, and asked to take weekly nasal swabs for 6 weeks (median: 3 weeks, range 1 to 6 weeks)...

Enteroviruses cause a variety of illnesses of the gastrointestinal tract, central nervous system as well as cardiovascular system. Phylogenetic analysis of VP1 sequences has identified 106 different human enteroviruses classified into four enterovirus species within genus Enterovirus of the Picornaviridae family. It is likely that not all enterovirus types have been discovered. Between September 2013 and October 2014, stool samples of 6274 apparently healthy children up to 5 years of age residing in Gorakhpur district, Uttar Pradesh, India were screened for enteroviruses...